CritMedic

Critical Care Paramedicine Podcast

Episode 12: Too tired to care?


Are we a danger to our patients and partners? Are we too tired to care?

This week, we discuss the ins and outs of fatigue and the effects it can have on us and our patients. We’ll draw on lessons learned from another mission critical profession where lives are in the balance. No matter how experienced or new the provider — no matter how highly trained — fatigue can effect ALL of us. We need knowledgeable people to take charge of the problem and help mitigate the risks — both from an individual standpoint and that of an agency.

 

 

Does your service have fatigue guidelines?

 

Mandatory Overtime

Some EMS services (mine included) are using what’s called “Mandatory Overtime” to fill scheduling vacancies. This means that an EMT or Paramedic is called and told they MUST show up for work at a certain time and place of the company’s choosing IN ADDITION to the regularly scheduled work. For instance, my personal schedule is a permanent 52 hour week — equivalent to working 9 – 5 Monday to Friday, 9 – 5 on Saturday, and 9-1 on Sunday. My company then tells me I have to come in for 6 – 12 more hours on a day of their choosing or face employment consequences.

EMTs and Paramedics work in a high stress, high risk field where the decisions and judgements they make can make an impact on the survival of the most acutely ill patients in our community. We work in often austere conditions with little direct supervision. Forcing those providers to work additional hours beyond what they feel they are capable of jeopardizes public health in by increasing the likelihood of committing a serious error. Furthermore, as EMS personnel have the responsibility to driving an emergency vehicle in hazardous conditions and an in a manner that does pose a measure of risk to the motorist public at large. We are expected to use due regard. And if we are fatigued due to overwork from involuntary mandatory overtime, our judgement may be impaired leading to a greater risk of accident.

EMS providers also have above average divorce rates and above average rates of depression and suicide (see the Code Green Campaign). Mandatory overtime deprives hardworking emergency service providers of the little amount of time they get spend with their families. Coupled with the effects of fatigue induced depression and other deleterious mental health impacts, Mandatory Overtime has the potential to disrupt the family structure of our first responders.

 

>>> Sign The Petition <<<

Providers in New York State are starting a push with the State Senators to end this practice. Nurses already have similar protections enacted that prohibit mandatory overtime except in the event of disasters. It’s time New York’s EMS personnel have the same protection. Nothing about this prohibits voluntary overtime — just mandatory overtime against the provider’s judgement and choice. If you’re in New York, please sign the petition!

 

Show Notes

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